Stricto sensu training: perspective of students of a nursing program

Abstract

Objective

To analyze academic training in a stricto sensu graduate program in nursing from students’ perspective.

Method

This is mixed methods, convergent parallel research, carried out with 91 students from a graduate nursing program in southern Brazil using an online questionnaire. Quantitative data were analyzed using descriptive statistics, and qualitative data were subjected to content analysis.

Results

Seventy students (76.9%) recognized improvements in their professional life and 74 (81.4%) felt motivated to take the courses. Mental distress (48; 52.7%), accumulation of work ties with course activities (46; 50.5%), lack of financial support for research (41, 45.1%) were related to demotivation. Of the respondents, 71 (78%) completely agreed with the program’s adherence to the nursing area, although the lowest percentage of agreement (n=69; 31.4%) occurred in the item referring to the discussion for periodic updating of production, articulation and adherence of research laboratories to the program’s research lines.

Conclusion

The graduate course has contributed to professionals’ qualification process such as professors, researchers and managers, leading to the conclusion that it is essential that programs have an understanding of the contributions that these courses bring to professionals and to health system improvement.

Education, nursing, graduate; Nursing education research; Education, nursing

Resumo

Objetivo

Analisar a formação acadêmica em um programa de pós-graduação stricto sensu em Enfermagem na perspectiva dos egressos.

Método

Estudo de métodos mistos, paralelo convergente, realizado com 91 egressos de um programa de pós-graduação em enfermagem da Região Sul do Brasil, a partir de um questionário on-line. Dados quantitativos foram analisados por meio de estatística descritiva e os dados qualitativos foram submetidos à análise de conteúdo.

Resultados

Setenta egressos (76,9%) reconheceram melhorias na sua vida profissional, e 74 (81,4%) se sentiram motivados para os cursos. Sofrimento mental (48; 52,7%); acúmulo de vínculos de trabalho com as atividades do curso (46; 50,5%); falta de apoio financeiro à pesquisa (41,45,1%) foram relacionados à desmotivação. Dos respondentes, 71 (78%) concordaram totalmente com a aderência do programa à área de enfermagem, embora que o menor percentual de concordância (n=69; 31,4%) tenha ocorrido no item referente a discussão para atualização periódica das Produções, Articulação e Aderência dos Laboratórios de Pesquisa às linhas de pesquisa do Programa.

Conclusão

O curso de pós-graduação tem contribuído para o processo de qualificação dos profissionais como professores, pesquisadores e gestores, levando à conclusão que é essencial que os programas tenham uma compreensão das contribuições que esses cursos trazem para os profissionais e para a melhoria do sistema de saúde.

Educação de pós-graduação em enfermagem; Pesquisa em educação de enfermagem; Educação em enfermagem

Resumen

Objetivo

Analizar la formación académica de un programa de posgrado stricto sensu en enfermería bajo la perspectiva de los egresados.

Método

Estudio de métodos mixtos, paralelo convergente, realizado con 91 egresados de un programa de posgrado en enfermería de la región Sur de Brasil, a partir de un cuestionario digital. Los datos cuantitativos fueron analizados mediante estadística descriptiva y los datos cualitativos fueron sometidos al análisis de contenido.

Resultados

Sesenta egresados (76,9 %) identificaron una mejora en su vida profesional y 74 (81,4 %) se sintieron motivados durante los cursos. El sufrimiento mental (48; 52,7 %), la acumulación de vínculos laborales y de actividades de los cursos (46; 50,5 %) y la falta de apoyo financiero a la investigación (41; 45,1 %) fueron factores relacionados con la desmotivación. De los encuestados, 71 (78 %) concordaron totalmente con la conexión entre el programa y el área de enfermería, aunque el menor porcentaje de concordancia (n=69; 31,4 %) fue en el ítem relacionado con la discusión sobre la actualización periódica de las producciones, la unión y la conexión entre los laboratorios de investigación y las líneas de investigación del programa.

Conclusión

Los cursos de posgrado contribuyeron al proceso de cualificación de los profesionales, como profesores, investigadores y gestores. Por lo tanto, se concluye que es esencial que los programas contemplen las contribuciones de estos cursos para los profesionales y para la mejora del sistema de salud.

Educación de postgrado en enfermería; Investigación en educación de enfermería; Educación en enfermería

Introduction

The expansion of the Brazilian Graduate System (SNPG) was a priority in all Brazilian National Graduate Plans (PNPG) and, especially in the last plan, in force from 2011 to 2020, the focus on consolidation and quality was expanded of existing programs. In Brazil, the overview of graduate education began to be monitored by a process that has as its presuppositions carrying out qualified and strategic research to achieve national or regional demands and goals.(¹) Although this assessment process is advanced and consolidated, when compared to undergraduate assessment, it is still a subject of debate.

Advances are recognized regarding the greater objectivity of the criteria; however, the inclusion of indicators that promote science and technology through classifications and rankings supports competitive and individualized productivism. They are not always qualified indicators regarding the real demands of today’s society or the inclusion of the person assessed,(²) as are based on an external quality approach to programs adopted by graduate funding agencies.(³)

In an attempt to improve the assessment process, the Coordination for the Improvement and Personnel of Higher Education (CAPES - Coordenação de Aperfeiçoamento e Pessoal do Ensino Superior) included self-assessment as an essential component. The proposal was based on the understanding that internal and self-managed assessment by its academic staff promotes self-reflection about the institution and the results obtained about its policies, context and decision-making, enabling the correction of trajectories and prospecting a future anchored in planning that provides real answers to society.(²,⁴)

In this process, student participation is important to help identify evidence to qualify the development of programs, especially regarding the curriculum, methodology and infrastructure. This understanding by CAPES, although not sufficient or with immediate effects on graduate programs, takes shape with the approval of the “Proposal for Improving the Graduate Assessment Model”, when student self-assessment and monitoring gain space after being secondary for a long time.(⁵) With this movement, graduate programs began to face the challenge of planning, implementing and developing actions aimed at assessment within the institutional space itself, developed through self-assessment working groups, whose information results in reports aimed at proposing improvements to graduate studies. Thus, assessment becomes a continuous process, which seeks not only to identify problems or points for improvement, but also to recognize and reinforce what is going well.(⁶)

The Graduate Program in Nursing at the Universidade Federal de Santa Catarina was created in 1976 with the master’s degree in nursing sciences. At the heart of its development was a self-assessment process that included professors and students aiming to recognize potential weaknesses, seeking to restructure the master’s degree and implement, ten years later, the doctoral course.(⁷,⁸)The purpose of beginning the doctoral course was to respond to nursing training’s demands, articulating the theoretical and philosophical constructions of disciplinary knowledge, with the provision of policies, systems, models, processes, techniques, instruments, assessments of care and/or intervention practices to respond to society’s demands in the field of health and nursing.(⁹)As a result of this construction, the program achieved an assessment of excellence by CAPES, with a score of 6 since 2012, revealing the importance of including self-assessment and students in this process.(⁵)

Thus, this study aimed to analyze academic training in a stricto sensu graduate program in nursing from students’ perspective.

Methods

This is mixed methods, parallel, convergent research, in which the two approaches were developed through an online survey, with an exploratory-descriptive nature. This mixed methods approach enables the simultaneous and independent collection and analysis of qualitative and quantitative data. At the end, the two databases are compared and integrated in order to identify convergences and divergences. The Mixed Methods Appraisal Tool (MMAT) was used as a methodological guide.⁽⁹⁾

Data collection was carried out from July to August 2022 online via Google Forms^®. All 226 students from the master’s and doctoral courses over the last five years (2017-2021) received the form via email, WhatsApp^® groups and/or the program’s social networks, with this period being established based on the monitoring criteria of CAPES students.

The response period was one month, with weekly reinforcement of questionnaire dissemination. In the end, a sample of 91 participants was obtained, which corresponds to 40% of students. The list of doctoral and master’s students who made up the 226 guests consisted of 137 master’s students and 89 doctoral students. As study participants, 50 respondents considered themselves doctoral students, and 41, master’s students.

The data collection instrument was composed of five parts: characterization form with variables regarding the socio-professional profile; professional performance in the last five years; motivation during graduate training; program proposal assessment, curriculum structure, infrastructure and visibility actions and training contributions; open-ended questions about training during graduate studies.

The quantitative stage considered parts one to four and specifically on the program assessment part, composed of 18 questions distributed according to the criteria: program proposal (seven items); curriculum structure (six items); infrastructure and visibility actions (two items); and training contributions (three items). The preparation of this questionnaire was based on the CAPES assessment instrument items. To assess each item, a five-point Likert scale was used: (1) Completely Disagree; (2) Partially Disagree; (3) Neither Agree nor Disagree; (4) Partially Agree; and (5) Completely Agree. Option (0) was used for “Do not know/Not applicable” in case of non-response. It was not necessary for students to justify their answer.

It is noteworthy that, before data collection, the instrument was assessed through its application with three students and language/semantics refinement, carried out by the team of researchers who were not included in the research. There were only editorial suggestions, which were incorporated into the instrument.

The quantitative data was analyzed using the Statistical Package for the Social Sciences (SPSS) for Windows version 19 using descriptive analysis. The qualitative stage was also developed based on the instrument sent via Google Forms^® individually. Open-ended questions were considered regarding the fifth part of the instrument, whose questions suggested any type of answer, given by respondents’ words and related to local, regional and national training needs, highlighting gaps or aspects not covered; program proposal, negative and positive aspects and/or suggestions; aspects considered as strengths and weaknesses or suggestions related to: curriculum structure; program infrastructure and visibility; graduate contributions to student training; professors’ performance; dissertation/thesis preparation; research actions; social inclusion of the program.

Participants’ answers were indicated by the letter P followed by a number from 1 to 91, exported to the Atlas Ti software version 1.0.45 (license 110271462) for data coding using content analysis.(¹⁰)In pre-analysis, the questionnaires were read and re-read for coding, independently, by two researchers. Then, by consensus, the relationship between initial codifications was established to accommodate idea clarity. The second stage, material exploration, consisted of grouping the codes to form pre-categories. In the software, each pre-category could be linked to the corresponding text segment in order to form the corpus of results. In the third stage, interpretation, the corpus was analyzed aiming to identify prevalent codes in each pre-category and their relationships with the analytical category.

Data integration occurred at the end of the analyses, based on comparison of data produced in the quantitative and qualitative stages.

Ethical recommendations were followed and the research was approved by the Research Ethics Committee through Certificate of Presentation for Ethical Consideration (CAAE - Certificado de Apresentação para Apreciação Ética) 60486922.6.0000.0121 and Opinion 5.646.037.

Results

Table 1 presents the sociodemographic and professional profile of participating students as well as variables regarding professional performance in the last five years.

Table 1
Sociodemographic and professional profile, professional performance in the last five years and motivation during graduate studies

		n(%)
Sociodemographic variables
Sex	Female	77(84.6)
	Male	14(15.4)
Race	White	78(85.7)
	Brown	11(12.1)
	Black	02(2.2)
Level	Post-doctoral degree	03(3.3)
	Doctoral degree	29(31.9)
	Master’s degree	38(41.8)
	Master’s and doctoral degrees	18(19.8)
	Master’s, doctoral and post-doctoral degrees	2(2.2)
	Doctoral and post-doctoral degrees	1(1.1)
Scholarship holder	No	50(54.9)
	Yes	41(45.1)
Year when received the title	2017	16(17.5)
	2018	13(14.2)
	2019	17(18.6)
	2020	20(21.9)
	2021	25(27.4)
Professional variables
Mean monthly income	Up to 3 MW*	13(14.3)
	From 10 to 20 MW	19(20.9)
	From 3 to 5 MW	25(27.5)
	From 5 to 10 MW	29(31.9)
	More than 20 MW	2(2.2)
	No income	3(3.3)
Holding a leadership/coordination/management position in the last 5 years	No	48(52.7)
	Yes	43(47.3)
Graduate program variables
Receiving financial support for the study (coordinator or project member)	No	76(83.5)
	Yes	15(16.5)
Participation in a funded project (coordinator or project member)	No	52(57.1)
	Yes	39(42.9)
Current participation in graduate program as an accredited professor	No	77(84.6)
	Yes	14(15.4)
Acting as a conclusion work advisor (current or previous)	No	36(39.5)
	Yes	55(60.4)
Current participation in a research group	No	06(17.6)
	Yes	85(93.4)

• n - number; MW - minimum wages, value of R$ 1,212.00, referring to 2022.

Most students, 70 (76.9%), reported recognition of improvements and/or greater recognition in their professional life, such as reaching higher positions or leadership after graduate training (MS/DO/PD), as, during such courses, 74 (81.4%) students felt frequently or very frequently motivated to take them, 14 (15.4%) felt occasionally motivated and three (3.2%) rarely motivated. It is noteworthy that when asked why they felt unmotivated, they reported factors associated with mental distress (48, 52.7%); accumulation of work relationships and course activity (46, 50.5%); lack of scholarship, financial support for research (41, 45.1%) or socioeconomic reasons (24, 26.4%); lack of support in guidance (23, 25.3%) or relationship with professor (22, 24.2%); lack of scientific reading and writing habit (10, 11%); lack of course planning and organization (9, 9.9%) or poor course management (6, 6.6%); poor infrastructure (7, 7.7%); and difficulties in recognizing the course objectives (3, 3.3%). The distribution of answers regarding student assessment in the areas of program proposal, curriculum structure, infrastructure and visibility actions and training contributions can be found in Table 2. However, it is worth highlighting that the highest level of agreement was evidenced in item “1.1. The program proposal adheres to the nursing area”, with which 71 (78%) respondents completely agreed. The lowest percentage of total agreement (n=69; 31.4%) was recorded in item “1.7 The studies, profile of participants, articulation and adherence of research groups/laboratories with the program’s lines of research are periodically discussed for updating”.

Table 2
Distribution of participants’ answers regarding program proposal assessment, curriculum structure, infrastructure and visibility actions

Answers	NA*	TD	PD	NAND	PA	TA
n(%)	n(%)	n(%)	n(%)	n(%)	n(%)	n(%)
Program proposal
1.1. The program proposal adheres to the nursing area.	0(0)	0(0)	3(3.3)	2(2.2)	15(16.5)	71(78)
1.2 The program’s areas of concentration are coherent. comprehensive and consistent.	0(0)	0(0)	2(2.2)	4(4.4)	22(24.2)	63(69.2)
1.3 The lines of research are coherent, comprehensive and consistent.	0(0)	0(0)	2(2.2)	4(4.4)	23(25.3)	62(68.1)
1.4 The relationship between areas of concentration and the program’s lines of research expresses articulation, adherence and is updated to the needs of knowledge production.	0(0)	1(1.1)	6(6.6)	3(3.3)	25(27.5)	56(61.5)
1.5 The program proposal is adapted to local, regional and national training needs.	0(0)	1(1.1)	6(6.6)	4(4.4)	29(31.9)	51(56)
1.6 The research groups/laboratories are articulated and adhere to the program’s research lines.	1(1.1)	0(0)	2(2.2)	3(3.3)	24(26.4)	61(67)
1.7 The studies, profile of participants, articulation and adherence of research groups/laboratories with the program’s lines of research are periodically discussed for updating.	5(5.5)	2(2.2)	5(5.5)	12(13.2)	29(31.9)	38(41)
Curriculum structure
2.1 The curriculum structure was adapted to the program proposal. in relation to the number and nature of the subjects offered (compulsory, elective, optional).	0(0)	0(0)	3(3.3)	4(4.4)	31(34.1)	53(58)
2.2 The curriculum structure was adapted to the program proposal, in relation to the workload of the subjects offered.	0(0)	0(0)	2(2.2)	5(5.5)	26(28.6)	58(63.7)
2.3 The program’s curriculum structure demonstrated a consistent theoretical-methodological foundation for research (epistemological and methodological bases of investigation).	0(0)	1(1.1)	4(4.4)	5(5.5)	23(25.3)	58(63.7)
2.4 The curriculum structure of the program included the basis of didactic-pedagogical training (for teaching).	1(1.1)	2(2.2)	6(6.6)	6(6.6)	24(26.4)	52(57.1)
2.5 The program’s subjects used problematizing and critical approaches and strategies and/or active learning methodologies, with formative assessment.	0	2(2.2)	2(2.2)	5(5.6)	35(38.9)	46(51.1)
2.6 The curriculum components included both the interdisciplinarity of health knowledge and the demands for the advancement of the nursing discipline.	0	2(2.2)	5(5.5)	10(11)	22(24.2)	52(57.1)
Infrastructure and visibility actions
3.1 The program website provides adequate and current information, including disclosure of events, notices, projects, agreements and other regulations or opportunities of academic/scientific interest.	0	0	7(7.7)	6(6.6)	24(26.4)	54(59.3)
3.2 You continue to access the program website or receive information from it via other communication channels.	5(5.5)	4(4.4)	5(5.5)	7(7.7)	19(20.9)	51(56)
Training contributions
4.1 Graduate training contributed to students expanding/improving their leadership and performance in management (positions in healthcare services).	1(1.1)	3(3.3)	3(3.3)	5(5.5)	30(33)	49(53.8)
4.2 Graduate training contributed to students expanding/improving their leadership and performance in teaching in higher education.	2(2.2)	1(1.1)	5(5.5)	4(4.4)	17(18.7)	62(68.1)
4.3 Graduate training contributed to students expanding/improving their leadership and performance in research (funded research projects and SI, TI, final course thesis, master’s or doctoral guidance).	0	1(1.1)	4(4.4)	4(4.4)	19(20.9)	63(69.2)

• NA - does not know/not applicable; TD - totally disagree; PD - partially disagree; NAND- neither agree nor disagree; PA - partially agree; TA - totally agree.

In qualitative analysis, two categories stood out. The category “Graduate program structural and social challenges” is supported by five subcategories (Program proposal, curriculum structure and its local insertion; Infrastructure and program visibility; Dissertation/thesis preparation; Internationalization, partnerships and funding; Social insertion). The second category “Graduate studies as a tool for expanding knowledge” is divided into two subcategories (Recognizing translation of knowledge as potential; Importance of internationalization and partnerships in research laboratories). The first category “Graduate program structural and social challenges” shows the multidimensionality of challenges that today impact and mobilize actions in Brazilian graduate studies in general. Students refer to a curriculum structure more focused on local regional needs, covering demands that arise from nurses’ care practice. They mentioned the importance of connecting with the job market’s current demands with a view to professional preparation for teaching and research.

“I would like some management and leadership disciplines as well as teaching skills”. (P32)

Still in this category, regarding the program infrastructure and visibility, the importance of disseminating research results to promote visibility is expressed. They suggested an emphasis on publicizing academic opportunities.

“I believe we can improve the program visibility [...] they need to publicize more about the excellent results of the research carried out”! (P60)

“It would be interesting to make events, notices, projects, agreements and other regulations or opportunities of academic/scientific interest available with greater emphasis”. (P2)

This category also highlights aspects related to dissertation/thesis preparation, requesting more courses aimed at preparing the products. They pointed out, in another aspect, the need for emotional support in the process.

A weak point would be the large number of course credits, making the development of dissertation or thesis somewhat difficult. (P11)

There should be greater support for students’ mental health. I see many co-workers getting sick. (P16)

From the perspective of internationalization, partnerships and fundraising, it signaled the fragile integration between the different research groups, which impacts the strengthening of projects and the consequent possibility of financing them.

“There is a lot being produced and even we, who are part of the program, don’t know about it.” (P54)

“[...] if laboratories carried out projects in partnership, articulated, the possibilities of funding from agencies would be even greater”. (P9)

With regard to social insertion, they suggest the dissemination of the program’s strengths, the commitment to return research to society.

“The course provides different opportunities for social integration, but we could review a greater form of interaction with the community”. (P23)

“The importance of commitment to giving back to society as well as through program and studies makes them significant for community change [...]”. (P22)

In all dimensions worked on in this study, competencies were highlighted that need to be maintained and strengthened in the program. The second category, “Graduate studies as a tool for expanding knowledge”, highlights the recognition of knowledge translation as a potential capable of promoting the local, regional and social insertion of graduate studies.

“The socialization of investigation results is fundamental. It is important to always include civil society and political representatives in this process”. (P43)

Still in this category, the importance of internationalization and partnerships in research laboratories stands out. Despite the need for expansion, internationalization was recognized as a strength.

“I believe that the program is very well articulated internationally, always offering the possibility of courses with guest professors from other universities”. (P20)

Research groups/laboratories are assessed as a constructive space for exchanging experiences and technical support for dissertation/thesis development.

“Research laboratories are essential for bringing together professors, students and technicians. Strengthen research and encourage learning”. (P76)

Although the qualitative data are described in an articulated way in two large interpretative sets (two categories integrating seven subcategories), which do not express an immediate correspondence with variables and quantitative data, important integrations between different findings are possible. Hence, it is noteworthy that there was a consensus on the relevance of the academic title for activities in management, teaching and research. Additionally, there was convergence regarding the importance of curriculum reform and emotional support during the graduate journey.

On the other hand, in the program proposal assessment and the category “Graduate program structural and social challenges”, divergences emerged, such as positive scores in all items of the proposal while suggestions for improvement were offered. In the infrastructure and visibility section, the program’s website stood out as an updated and adequate source of information. However, qualitative data points to the need for greater investment in dissemination, especially the results of research carried out by the academic community. Another discrepancy emerged in the topic about the adherence of research groups/laboratories to the program’s lines of research, with less agreement in quantitative analysis and emphasized as a space for exchanging experiences and developing dissertations/theses on qualitative data.

Discussion

This study’s distinguishing feature is the presentation of qualitative findings that complement and incorporate new contributions about the program, from students’ perspective, and not just the reaffirmation of what has already been evidenced by quantitative variable analysis. Thus, the discussion was structured to highlight relevant issues and insights promoted by integration of data from both approaches.

One of the main points of convergence between quantitative and qualitative results was students’ recognition of the academic title’s contribution to current professional activities’ performance. After the degree, improvements are achieved for professional life such as leadership, direction and coordination positions in healthcare services and educational institutions.(¹¹) There is also evidence about inclusion in scientific actions, projects and research groups, and in academic orientations.(¹,¹¹,¹²)

The motivation for seeking stricto sensu training can be justified by the interest and need to produce knowledge for professional performance not only in teaching, but also in highly specialized care areas, research and management areas.(¹³,¹⁴)On the international scene, motivation was also related to the search for meaning and purpose in care, satisfaction or change of career direction, in addition to financial advantages.(¹⁴)

In the program proposal assessment and the category “Graduate program structural and social challenges”, there are apparent divergences, such as positive scores in all items of the proposal (score 4/5 or 5/5 on the scale) and, at the same time, suggestions for changes and improvements. The issue about the curriculum structure provides a consistent theoretical-methodological foundation for the research (89% scoring 4 or 5) does not mean the absence of suggestions for curriculum changes, or reported needs regarding the moment of construction of the thesis, for instance. The central tone of data integration was shown in a logic that could be summarized in the paradox between quality and consistency x flexibility and change. Therefore, despite a great recognition of training quality, there are limits and needs that demand quick responses from new methods, techniques, references, for which the very notion of “structure” has difficulty responding. A structure needs to meet common and central axes and offers for training and at the same time be open to new trends and specific dialogues. This is a permanent graduate task.

In an international context, even when there are clear recommendations for national training standards to meet specific demands (such as a doctoral in nursing practice), their adoption seems inconsistent and difficult,(¹⁵) requiring understanding of the context of gaps and challenges for students, academic and clinical environments, professors and managers.(¹⁶) Furthermore, there is a lack of rigor and coherence in terms of nomenclature, curricula and academic results, which require intense assessment, leading to admission that with each solution to a problem a new one is generated (e.g., strengthening the structure of disciplines and weakening the preparation for research).(¹⁷)

Explaining this apparent paradox makes it easier to understand why the program’s curriculum proposal also contains one of the main points of convergence – the majority of students consider curriculum reform necessary. In the qualitative findings, the suggestion of a curriculum structure aimed at local regional needs to address clinical and care issues of nurses in connection with the job market stood out. Graduate courses must be open to the current trend in the job market, which seeks qualified professionals for relevant positions in their institutions.(¹,¹²)

In Brazil, doctoral students in nursing identified the highest concentration of activities in teaching, research and management of healthcare services.(¹²) One finding of this study refers to the positive assessment of the graduate contribution to leadership and performance in management, teaching and research (items 4.1 to 4.3 of Table 2) and justifies the suggestions regarding the curriculum (qualitative data). The importance attributed to these performances (convergence of quantitative and qualitative data) is observed, consistent with the relevant insertion of most students in research groups after training, but inconsistent with non-significant accreditation as a professor in the graduate program. Obviously, this limit needs to be set in time (short completion time, between 1 and 5 years) and by level of training (of the 91 respondents, 53 have doctoral degree and only 14 are accredited in the graduate program).

On the other hand, occupational data must be considered in scenarios of economic crisis, which reduce jobs in academia and research. Furthermore, there is a serious inequality in possibilities of access to the academic world between countries, substantially altering the fate of doctors in various areas.(¹⁸)

Brazilian graduate nursing programs’ curriculum is based on lines of research and areas of concentration. In this way, training is focused largely on the specific line, area and topic of study.(¹⁹) Therefore, such an organization may not encourage experiences that go beyond this scope, as occurs with some optional subjects, associated with the main space occupied after the training of this master’s/doctoral degree, which are not chosen by graduate students. Studies reveal, for instance, didactic-pedagogical subjects that are not mandatory in some doctoral courses, even though the teaching area is the work space that most welcomes students.(¹⁹,²⁰)According to students, despite the desire of graduate students to work in teaching, there are weaknesses in training in disciplines focused on instrumentation for an academic career. Discussion about adequate preparation for the role of educator in doctoral courses is growing in North America, for instance, pointing out the risk of non-compliance with this professional responsibility by reinforcing the research versus teaching controversy and an orientation towards research already strongly leveraged by epistemic cultures and assessment and productivity systems in academia.(²¹)

When doctoral training in nursing focuses less on specific content and more on building thinking and method skills, commitment to continuous training is strengthened, assuming that no program or course can be conclusive in training researchers,(²²) but can strengthen professional values and attributes for the expression of leadership.(²³)

Graduate studies were tasked with contributing to the scientific, economic, technological and social progression of the country.(⁴)Therefore, training and research must be in tune with the reality of work, education and health system’s needs. The Ministry of Health indicates the urgency of prioritizing studies on the main diseases and health problems and cross-cutting issues, such as public policies, systems and health determinants.(²⁴) Furthermore, the international challenge is for nurse scientists to combine the incorporation of technological advances with promotion of equity in health, which includes new ways of engaging with underrepresented populations, new strategies for diversity and collaboration with communities.(²⁵)

Curricula should emphasize topics in light of the expected profile of graduate nursing students.(²⁶)Nursing is an area of knowledge involved in social practices, with a need for interaction between knowledge from the biomedical, human and social areas. To this end, there must be conciliation between other areas to develop practices in line with healthcare services.(²⁷)

Therefore, it is necessary to overcome the predominantly disciplinary training, which places the multi-professional and interdisciplinary reality in second. The effective participation of professors and students in the services occupied by nursing is imperative, aiming to respond to healthcare institutions’ practice in the different contexts of the Brazilian Health System (SUS).(²⁶) Efforts in graduate studies must include academic productivity, foreseeing steps following nurse scientist and leader training and preparation.(²⁸)To this end, specifically the doctoral must be oriented towards innovation skills, methodological mastery and problem solving, for which interdisciplinary and team scientific experiences are fundamental.(²²)

The need for emotional support during graduate studies was consistent with the percentage of students who indicated factors associated with mental distress as limiting motivation in the training process. Despite the lack of dropout rates in the context assessed, another study reveals a dropout rate of more than 22% in North American programs. In this case, the main stress factor pointed out was the proportion of online activities despite teaching staff qualifications and infrastructure available to carry out the research.(²⁹) International programs aim to support rapid completion of doctoral courses by nurses, assuming that funding (scholarships) and planned duration are attractive while guidance, access to information and support network are facilitators for successful completion.(³⁰)

The result of this study may be related to stressful factors involved in the graduate modus operandi, such as competitiveness among peers, accelerated productivism and isolated training of students.(³¹) This context does not only affect nursing, but echoes in other areas,(³²)announcing the need for attention under the CAPES guidelines, which define the pace of Brazilian graduate training on all its fronts.

Regarding infrastructure and visibility actions and adherence of research groups/laboratories with the program’s lines of research, there were also divergences between quantitative and qualitative results. In this case, in the infrastructure and visibility actions dimension, the program website was considered a source of adequate and current information. However, qualitative analysis shows the need for greater investment in dissemination actions, especially the results of research developed by the academic community.

The use of websites in educational contexts is increasing day by day. The impact of technology on the educational system provides immediate content delivery, meeting much of the demand for learning updates.(³³) If integration of technology in the teaching-learning process helps in the creation of formative learning, it also creates clashes and difficulties between generations, as it imposes a reconfiguration of pedagogical actions(³⁴) and use of new communication tools,(³⁵)active methodologies, virtual and digital teaching, including online guidance.(²²)

Another point of disagreement was in relation to the item about the adherence of research groups/laboratories to the program’s research lines, which obtained the lowest level of agreement in the quantitative stage. However, qualitative data indicated the importance of these spaces for exchanging experiences and developing dissertations/theses. As it is a program that promotes the training of students from different areas other than nursing, students’ and supervisors’ performance and dedication to scientific production over the years is diverse. It is not only directed to the main focus of research groups/laboratories, but it encompasses their objectives. A stricto sensu graduate program aims to train professionals aware of new knowledge and capable of monitoring innovation processes, developing projects to solve problems observed in their area of activity.(⁹,³⁶,³⁷)

Insertion and participation in nursing research groups is a differentiator in the training of new researchers, as it allows contact with more experienced researchers and teamwork with co-workers from different levels of training. In these environments, debates take place, joint research is carried out, scientific articles and other proposals for healthcare and teaching take place, based on the diversity of thinking styles.(³⁸,³⁹) Furthermore, in research groups, the value of orientation experiences and ways of continuing them after training as inducers in the roles of novice scientists is reinforced.(³⁰)

As limitations of this study, the use of convenience sampling and a specific questionnaire were considered, as no validated instruments were identified for the object under investigation. New research is necessary to reinforce and/or advance in relation to the findings obtained with a view to obtaining subsidies for continuous improvement of graduate studies.

Conclusion

The program assessment from students’ perspective was mostly positive, given the stricto sensu training contributions in professional qualification, since there is consensus on the academic title’s relevance for work in management, teaching, research and greater recognition in professional life in reaching leadership positions. Additionally, there was also consensus regarding the importance of curriculum reform and emotional support during the graduate journey. On the other hand, when it comes to structural and social challenges, there are divergences that suggest improvements in infrastructure and visibility actions, mainly regarding the research results developed and adherence of research groups/laboratories to the program’s research lines. Thus, the need for continuous reviews of the program proposal is evident, with an emphasis on monitoring new trends in care practice, research priorities based on regional needs for healthcare services, roles and expectations for teaching and research and incessant transformations in the political and scientific context of the profession.

Acknowledgments

This work was carried out with the support of the Coordination for the Improvement of Higher Education Personnel (CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), Funding Code 001.

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Edited by

Associate Editor: Juliana de Lima Lopes (https://orcid.org/0000-0001-6915-6781) Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil

Publication Dates

• Publication in this collection
  13 Sept 2024
• Date of issue
  2024

History

• Received
  28 Apr 2023
• Accepted
  20 Mar 2024